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HAY FEVER 



OR 



RHINITIS VASO-MOTORIA PERIODICA 



AND ITS RADICAL CURE 



E. LIPPINCOTT, M.D. 

MEMP.ER OF THE AMEKICAN INSTITUTE OF HOMfEOPATHY ; SOUTHERN 

HOMOEOPATHIC MEDICAL ASSOCIATION; AMERICAN PUBLIC 

HEALTH association; AMERICAN 

OBSTETRICAL ASSOCIATION. 



CHICAGO 
GKOSS & DELBRIDGE 

1888 




x'^fV 





COPYRIGHT 

GROSS & DELBRIDGE 

1888 



PEEFACE. 

Worthy objects often suffer at the hands of 
zealous, though injudicious friends. The hter- 
ature of our school on the subject of hay fever, 
though scanty, consists, for the most part, of 
treatises which exhibit a woeful lack of exact 
knowledge. The reflections to which this gives 
rise are not pleasant to those who have at heart 
the best interests of a rational system of medi- 
cine. Our works on hay fever are signally 
deficient regarding the etiology and pathology 
of the disease, while the therapeutics presented 
are meagre and empirical, and, in some respects, 
calculated to mislead. It is the poverty of our 
literature on the subject which has prompted me 
to offer to the profession this monograph. I do 
so in the hope that the suggestions and the in- 
formation which it contains may be of some 
service in aiding them not only to relieve, but to 
cure many of that great army of sufferers who, 
I am sure, would be willing to cast golden treas- 
ures at their feet. 

In spite of its possible inaccuracies I trust 
that it may merit recognition, and that criticism 
may be unreserved and just. 

E. LirriNcoTT. 
Memphis, Tenn., 
September 1st, 1888. 



CONTENTS. 

Chapter I. 

Synonyms.— Definition. — Varieties. — Geograph- 
ical Distribution 7 — U 

Chaptee II. 
History 15—21 

Chapter III. 
iEtiology 22—27 

Chapter IV. 
The Parts Affected 28—31 

Chapter V. 
Pathology 32—35 

Chapter VI. 

Diagnosis. — Prognosis. — Sanitary Resorts 36 — 38 

Chapter VII. 

Treatment 37— tl:6 

« 

Chapter VIII. 
Therapeutic Indications 47—76 



HAY FEYEE; 

RHINITIS VASO-MOTORIA PERIODICA. 
Chapter L 

Synonyms. — Asthma iEstivum (Summer 
Asthma) ; Chortasthma ; Grass Asthma ; Hay 
Asthma ; Pollen Asthma ; Eye Asthma ; Asth- 
matic Bronchitis ; Summer Bronchitis ; August 
Catarrh ; Autumnal Catarrh ; Bostock's Catarrh ; 
June Catarrh ; Nervous Catarrh ; Pollen Catarrh ; 
Eose Catarrh ; Spasmodic Catarrh ; Catarrhus 
iEstivus (Summer Catarrh) ; Hay Cold ; June 
Cold ; Peach Cold ; Eose Cold ; Yearly Cold ; 
Gouty Coryza ; Idiosyncratic Coryza ; Paroxys- 
mal Coryza ; Dust Fever ; Pollen Fever ; Eag- 
weed Fever ; Eose Fever ; Summer Fever ; Sun 
Fever ; Glanderoid ; Asthmatic Influenza ; Pol- 
len Poisoning ; Periodic Ehinitis ; Ehinitis Sym- 
pathetica ; Ehinitis Vaso-motoria ; Coryza Vaso- 
motoria Periodica. French — Asthma cVete, Ger- 
man — Roggen Asthma; Fruhsommerkatarrh , 

These numerous synonyms are objection- 
able, for they are misleading as to cause, time 
of onset, course and nature of the disease, hav- 
ing been intended, obviously, by their various 
authors, to indicate either the name of the 
writer who first described the disease, the time 
or supposed cause of its appearance, the parts 
affected, the pathology, mode of manifestation, 
or resemblance to other diseases. 



8 RAY FEVER. 

The terms ''hay fever" and "hay asthma" 
are indisputably misnomers, in that they ex- 
press neither the nature nor the cause of the 
disease. While pollen from hay, in common 
with other kinds of pollen, as well as dust, odors, 
fumes, gases, heat, light, etc., may be the excit- 
ing causes of the disease, yet many people suffer 
from attacks into which neither liay nor fever 
enter as a factor, either causative or symp- 
tomatic. But the terms have become so firmly 
fixed in the popular mind, and so thoroughly 
incorporated into the medical literature of the 
day, that, for convenience of expression, I shall 
hereafter use them in their conventional sense. 

My object in presenting the term. Rhinitis Vaso- 
motoria Periodica, as being the most appropriate, 
is not to involve the absurdity of associating a 
disease with an impossible cause, but to define 
the seat of the lesion, and to demonstrate that 
the affection depends upon engorgement and 
h^^peraesthesia of the nasal mucous membrane, 
with which are associated certain reflex nervous 
phenomena. 

Deflnition. — Hay fever, so-called, is an an- 
nually recurring affection which involves the mu- 
cous membranes of the ocular, aural and respira- 
tory tracts, depending upon engorgement and 
hyperaesthesia of the nasal mucous membrane, 
and accompanied by the following symptoms : — 
Periodic and spasmodic attacks of acute rhinitis, 
rhinorrhoea, itching and irritation of the nose, 
eyes, ears, mouth, pharynx, larynx, and bronchi ; 



HAY FEVER. d 

mild or violent attacks of sneezing; copious, 
watery discharge from the nares, either bland, 
or of an acrid, salty taste, excoriating the nose 
and upper lip ; redness and swelling of the 
nares ; swelling of the submucous tissue of the 
nares, with more or less occlusion and some- 
times epistaxis ; lachrymation, redness and suffu- 
sion of the eyes ; swelling of the submucous 
tissue and consequent stenosis of the lachrymal 
canals and nasal ducts ; photophobia ; conjunc- 
tivitis ; sometimes, but rarely, oedema of the 
eyelids ; chilliness ; aching ; slight febrile dis- 
turbance in some cases ; pressure and heaviness 
in the frontal sinuses and forehead, or headache ; 
neuralgia; flushed face; hacking, deep, hollow 
or wheezing cough ; sleeplessness ; loss of appe- 
tite ; sensitiveness to cold air, change of tem- 
perature, drafts, sunlight, heat, pollen, dust, 
smoke, odors, fumes, perfumes, and other ex- 
ternal impressions or irritants ; in some instances 
papular eruption over the extremities ; burning 
sensation in the bronchi and lungs ; bronchial 
irritation or bronchial catarrh ; tightness of 
chest ; difficult and wheezy breathing with pro- 
longed expiration, and other asthmatic symp- 
toms ; more or less cough, followed, at the close 
of the attack, by expectoration, the advent of 
the cough being generally accompanied by asth- 
matic symptoms of more or less severity ; greater 
or less impairment of the senses of taste and 
smell, together with general discomfort and such 
a degree of physical and mental depression as to 



10 HAY FEVER, 

render the sufferer unfit for physical or mental 
effort; the attacks recurring annually with 
almost minute exactness in point of time, last- 
ing four to eight weeks, and occurring in most 
cases throughout the remaining years of life, 
leaving little or no trace of its presence either in 
local lesion or systemic disturbance. The spells 
of sneezing or cough, with many of the other 
symptoms and conditions, are spasmodic, and 
appear or are aggravated at certain hours of the 
day or night.* 

Varieties. — There are two varieties of this 
affection, known as '' Eose Cold," or "June 
Catarrh," and "Hay Fever," or "Autumnal 
Catarrh," both of which, to a greater or less 
degree, simulate catarrh and asthma in their 
manifestations. The first variety occurs in this 
country, as regards time, from the last week in 
April, to June, and corresponds with the " Hay 
Fever " of Europe in time of development, 
but not in severity of attack, the " Hay Fever " 
of Europe being more severe. In rose cold 
we rarely have asthmatic complications, but 
they are of frequent occurrence in the autumnal 
variety. Eose cold disappears spontaneously in 
June or July in some cases ; in others it con- 

*A young lady whom I treated for rose cold June, 
1885, had periodical sneezing spells at midnight that 
lasted an hour, witk a return of the same in the morn- 
ing on rising, of shorter duration and less severity. 
With the hay-fever patient it appears on any day, 
much like the ^'Lancashire Folklore" Sunday sneeze: 
"Sneeze on Sunday, your safety seek, 
'*The Devil will have you the whole of the week." 



HAY FEVER. 11 

tinues later, or until the appearance of frost, 
with only an occasional sneeze or succession of 
sneezes, or with the usual hay-fever symptoms 
and conditions, with the exception that it is 
generally in a milder form than that which 
characterizes the autumnal variety. The hay 
fever of Europe usually occurs about May 25th, 
and rarely continues later than July. The 
second or autumnal variety appears from July to 
September — generally from August 10th to Sep- 
tember 10th — in America. The difference in 
the character and severity of the attacks, and 
time of appearance of the two varieties, is due to 
the season of the year in which the exciting 
causes operate or exist, the kind and character 
of the irritants, the character of, as well as the 
greater or less extent of the abnormal condition 
of the nasal cavities — which is the prime cause 
— the varied susceptibility and the latitude and 
altitude of the residence of its victims. Dr. M. 
Hyman, of Boston, doubts the essential identity of 
the two varieties, for the reason that the same 
exciting causes are not equally operative, and 
also because relief is afforded from the rose cold 
by a resort to the sea shore ; while the subject 
of the autumnal variety must resort elsewhere. 
He grants, however, that the objective phe- 
nomena are essentially alike, differing only in 
severity, and admits that the rose cold often 
seems to lead to the later one eventually, only 
yielding its victims when the severer form is de- 
veloped. 



la HAY FEVER, 

Although vegetation is earher in the South 
than in the North, the autumnal variety appears 
earlier in the North than in the South. It ap- 
pears in Colorado, Minnesota, Wisconsin, Iowa, 
Michigan, Northern New York, Vermont, New 
Hampshire, Maine and Massachusetts, from the 
last week in July to August 5th ; in Connecticut, 
and New York, August 10th; In Pennsylvania, 
New Jersey, Ohio, Indiana, Illinois, Missouri and 
Kansas, August 15th; in Delaware, Maryland, 
Virginia and Kentucky, August 20th ; in North 
Carolina, South Carolina, Tennessee and Ark- 
ansas, August 25th; in Georgia and Northern 
Mississippi, August 28th to September 1st; vol 
Florida, Alabama, Mississippi, Louisiana and 
Texas, September 5th to 10th ; continuing in the 
majority of cases until frost or cold weather 
checks the inflorescence of plants and maturing 
vegetation. 

The autumnal variety appears in two forms, 
the catarrhal, so-called, and the asthmatic, the 
catarrhal often lapsing into or being accompan- 
ied by the asthmatic. 

Each form is made up of three stages : first, the 
stage of development; second, the paroxysmal 
stage ; third, the stage of convalescence. The 
catarrhal form appears as heretofore described 
under the definition of hay fever, the symptoms 
varying in different individuals. The asthmatic 
form is, in addition, constantly accompanied by 
more or less dyspnoea and laryngo-bronchial 
catarrh. Its asthma is peculiar, in that it gene- 
rally occurs most frequently during the day, at 



BAY FEVER. 13 

least more frequently than in other forms of 
asthma, and varies from slight dyspnoea and 
moderate cough, to an intense and distressing 
dyspnoea and severe bronchial cough. The hay- 
fever victims of America, who are subject to the 
autumnal variety, have immunity from the 
disease in Europe, at the time they would be 
affected here. It is claimed by Sajous and a 
few other writers that ''the affection presents 
itself twice in the year, in some individuals, 
while in others it either occurs in May or June, 
or during the last two weeks of August, or early 
in September. " I have never known of a patient 
who had two attacks in one year. This affection 
is very rare among young children. Sir Morell 
Mackenzie, and one or two other writers, claim 
to have seen it as early as the second year of 
€hildhood. Were not this statement made by 
men of acknowledged ability there w^ould be 
reason to doubt the correctness of the diagnosis. 
Geographical Distribution — ^In this coun- 
try the boundaries of the variety denominated 
*' rose cold " have not been defined, but I have 
never met with it except in the Southern States. 
Hay fever is found almost everywhere, except 
in very cold countries, in elevated regions, 
and, in some instances, on islands. Dr. M. Hy- 
man's statements with reference to the geo- 
graphical distribution of the disease in this 
country, are incorrect. He believes that the 
autumnal variety does not extend south of the 
Ohio Eiver, north of the great lakes, or west of 
the Mississippi Eiver. He claims that certain 



14 ffAY FEYEE. 

portions of the country intervening are also ex- 
empted, as follows : A section lying north and 
east, adjacent to the White Mountains; also 
that portion of the state of New York north of 
Lake George, and extending west nearly to 
Ogdensburg, and the southern tier of counties 
from the Catskills, west to the state line ; again, 
that portion of the Alleghany mountains south 
of the head waters of the Juniata Eiver, to 
Covington, Kentucky. He believes these boun- 
daries to be approximately true, varying with 
the season. The extension of the disease be- 
yond these limits, northward, is only observed 
in seasons of unusual and protracted heat. In 
the summer of 1874 the autumnal variety 
reached northward beyond Mackinac (its usual 
boundary), even to the northern shores of Lake 
Superior, a region never before visited by this 
disease. It exists in Europe generally, but it is 
by far most common in England, where the an- 
nual number of cases is supposed to be double 
that of any other country. 



Chapter II. 

History. — This disease was first known or 
written of in England, having first made its ap- 
pearance there. On page 191 of the second 
volume of the "Practice of Physic," by William 
CuUen, M.D., published in 1793, under the head 
of Asthma, he says : '' In some persons the fits 
are readily excited by external heat, whether of 
the weather or of a warm chamber, and par- 
ticularly by warm bathing. In such persons fits 
are more frequent in summer, and particularly 
during dog-days, than at colder seasons." 

Judging from the above. Dr. CuUen must have 
met with hay asthma in his day. Hay fever 
was first written of by Heberden, who made 
some remarks which show that he had recog- 
nized the affection as distinct from the usual 
catarrhal and asthmatic troubles, and unique in 
its annual recurrence. He ventured no opinion 
concerning its causes, and did not seem to know 
anything of its real nature. It was first de- 
scribed by Dr. John Bostock, of London, in 1819, 
in a paper read before the Medico-Chirurgieal 
Society of London, in which he described his own 
case under the title of, ''A Case of the Periodi- 
cal Affection of the Eyes and Chest." This gave 
origin to the term ^'Bostock's Catarrh." In 
1828 he read a second paper on this subject be- 



16 HAY FEYEB. 

fore the same society, and gave a more length- 
ened account of the clisease, paying attention to 
special symptoms which distinguish it from 
other complaints resembling it. In his second 
paper the disorder was called ''Catarrhus iEs- 
tivus," or " Summer Catarrh." He described a 
form of the affection corresponding in its main 
features with what is now known as '^Eose 
Cold," or ''June Catarrh." In the nine years 
intervening between the two papers, no other 
notice of the disease appeared in printed form, 
but Bostock had either seen or had received 
distinct accounts of eighteen cases in addition 
to ten others in which the accounts were less 
perfect. 

In 1828, Dr. MaccuUoch mentioned the dis- 
ease, and in speaking of its causes, said: ''It 
is produced by hot-houses, or green-houses, and 
in the public estimation it is particularly 
caused by hay fields." In 1829, Mr. W. Gordon 
published his " Observations in the Nature, 
Cause, and Treatment of Hay Asthma." In 
1830 Mr. Augustus Prseter published a short 
notice of a case he had seen in Paris, some 
years before. Dr. EUiotson noticed the disease 
in his lectures in 1831. In 1833, he gave a 
fuller account of the malad3\ In 1839, he men- 
tioned pollen as being the probable cause of the 
affection. 

In 1854, Dr. Phoebus (professor of medicine 
at the University of Giessen) gave an analysis 
of 300 cases. In the early part of 1859 he sent 
out circulars, which were published in various 



HAY FEVER. 17 

medical journals in Europe and America, invit- 
ing medical men all over the world to send him 
answers to a series of questions so framed as 
to embrace every possible kind of information 
about the causes, symptoms, and progress of the 
disorder, its periods of prevalence, geographical 
and ethnological distribution, and its prevention 
and treatment. Although this disease is more 
prevalent in England and America than in any 
other parts of the world, it was to the above 
mentioned German author. Dr. Phoebus, that 
we are indebted for collecting and putting into 
an available form all that was known of hay 
fever up to the time of the appearance of his 
monograph in 1862. He was not himself a suf- 
ferer from the disease. 

In 1860, Dr. George Wyld, of London, gives 
as the probable cause, " the pollen of hay float- 
ing in the air." In 1865, Dr. Wm. Abbotts 
Smith issued a second edition of his '^ Observa- 
tions on Hay Fever, Hay Asthma, or Summer 
Catarrh." In 1866, a fourth edition of the same 
work appeared. In 1867, Dr. Wm. Pirrie is- 
sued a monograph on ''Hay Asthma, or the 
Affection termed Hay Fever." In 1869, Dr. 
George Moore issued a monograph on " Hay 
Fever, or Summer Catarrh : its Causes, Symp- 
toms, Prevention and Treatment." In. 1868 the 
distinguished physiologist, Helmholtz, claimed 
to have discovered in the nasal secretions of 
hay fever patients, certain low vegetable para- 
sites — vibriones — to which he ascribed the 
origin of the disease. This discovery was after- 



18 HAY FEVEE, 

wards said to have been confirmed by several 
others. On the other hand, other microscopists 
of equal reputation have failed to substantiate 
the discovery, even with high magnifying powers. 
In 1870, Dr. W. C. Eoberts published a jDaper 
on ''Catarrhus ^stivus. Hay, Eose, or Peach 
Cold, or Asthma," in the New York Medical Ga- 
zette, Oct. 8th, 1870, in which he claims priority 
of discovery of, and wished due credit awarded 
for, the symptom of excessive coldness of the 
end of the nose, w^hich he considers ''as the 
pathognomonic one." 

In 1872, Dr. Morrill Wyman, of Harvard 
University, published a work on ''Autumnal 
Catarrh," containing a record of eighty-one 
eases, and maps giving the boundaries of its dis- 
tribution throughout the United States. He 
deals with the question of heredity, as well as 
the geographic and chorographic relation of the 
malady. Although a sufferer from the disease, 
he does not seem to have any settled or exact 
opinion of the nature of its cause. 

In 1873, Dr. George M. Beard, of New York, 
published a treatise on " Hay Fever," or " Sum- 
mer Catarrh," and in 1876, published a mono- 
graph on the same, in which he attempts to 
demonstrate that a large per cent of hay fever 
sufferers are of the nervous temperament, and 
that the exciting causes are very numerous, and 
not limited to pollen, as had previously been 
maintained by the majority of writers. 

In 1873, Dr. C. H. Blackley, of Manchester, 
England, reiterated Elliot son's opinion, that the 



HAY FEYER. 19 

affection is caused by pollen, and demonstrated 
by a series of experiments — which began in 1859 
— its role as a causative influence in this disease. 
In 1880, in his " Hay Fever, its Causes, Treat- 
ment, and Effective Prevention, Experimental 
Eesearches, Second Edition," he has sifted and 
re-arranged this mass of evidence after a more 
logical method, and collected additional evidence 
to substantiate it. 

In 1875-76, Dr. Elias J. Marsh, of Paterson, 
New Jersey, made experiments on the causes of 
hay fever, after the plan pursued by Blackley, 
recommended in the first edition of his work. 
In 1877, he read an essay, on ''Hay Fever, or 
Pollen Poisoning," before the New Jersey State 
Medical Society. He attributes the cause to 
pollen. To him we are indebted for the term 
" Eag-weed Fever." 

In 1882, Dr.W. H. Daly, of Pittsburg, Penn., 
published a treatise, in which he attributed the 
cause of the annually recurring attacks of hay 
fever *'to local chronic disease of the nasal cav- 
ities, upon which the exciting causes act with 
effect," adding that " the parts should be put in 
order, and thereby enable them to withstand the 
exciting influence of the next recurring crop of 
bacteria." Dr. Daly was the first writer to call 
the attention of the profession to, and to dem- 
onstrate, the relation of hay fever and disease of 
the nasal cavities. In the ^ew York Medical 
Journal, May 12th, 1883, Dr. John 0. Eoe advo- 
cated the same theory, and stated ''that liyper- 
sesthesia is associated with, or occasioned by, a 



20 HAY FEYEE. 

diseased condition, either latent or active, of the 
naso-pharyngeal mucous membrane," and ^^that 
the removal of the diseased tissue in the nasal 
passages removes the susceptibility of the in- 
dividual to future attacks of hay fever." 

Dr. C. E. Sajous, of Philadelphia — unac- 
quainted with the papers of Daly and Eoe— - 
published an essay entitled " Notes on Hay 
Fever," in the Medical and Surgical Reporter, 
Dec. 22nd, 1883, in which he advanced the 
opinion " that hay fever was due to an idiosyn- 
crasy on the part of certain individuals to 
become affected by certain emanations ; that 
organic alteration of the surface of the nasal 
mucous membrane altered its sensibility and 
destroyed what morbid irritability might have 
attended the nervous filaments distributed over 
it," and, furthermore, that '' hypertrophies of 
the nasal membrane increased its irritability and 
the intensity of the symptoms." In 1885, he 
published a monograph on '^Hay Fever, and Its 
Successful Treatment by Superficial Organic 
Alteration of the Nasal Mucous Membrane," 
illustrated with thirteen wood engravings. 

Dr. Harrison Allen, of Philadelphia, in an 
article in the American Journal of the Medical 
Sciences, January, 1884, on the treatment of hay 
fever, attributed the disease to permanent or 
temporary obstruction of one or both chambers, 
and advanced the opinion that by overcoming 
this obstruction by the usual methods, a cure 
could be effected. 



HAY FEVER. 21 

In the New York Medical Record, July 19, 1884, 
Dr. J. N. Mackenzie, of Baltimore, suggested 
the term ^^Coryza Vaso-Motoria Periodica," 
on the ground that ''the disease is essentially 
a coryza, showing, in most cases, a decided 
tendency to periodic recurrence, and dependent 
upon some functional derangement of the nerve 
centres as its predisposing cause." 

In 1884, Dr. Morell Mackenzie, of London, 
delivered a lecture at the London Hospital Med- 
ical College, in which he favored the pollen and 
idiosyncratic theories. 



Chapter III. 

JItiology*— Dr. C. H. Blackley says : ^^The 
successful elucidation of the aetiology of disease 
is fraught with consequences the value of which 
it is scarcely possible to estimate, and it is prin- 
cipally on account of its intimate connection 
with the physical well-being of mankind, that w^e 
ought to be desirous of laying bare its secrets." 

Since 1819, when Bostock first described the 
affection, numerous and diversified theories have 
been advanced to explain its causes and the 
phenomena of its periodicity, among which are : 
(1). That it is caused by the lodgment in the 
nasal cavities of the pollen of plants, grasses, etc., 
floating in the atmosphere, which, being inhaled, 
produce in them a special irritation, which ex- 
cites more or less systemic disturbance of other 
parts and organs. (2). That it is caused by the 
lodgment or development in the nasal cavities 
of vibriones, or minute organisms, which induce 
the attendant symptoms. (3). That it is a 
functional disease of the nervous system — a 
neurosis. (4). That it is due to an idiosyn- 
crasy, or constitutional diathesis. (5). That 
its causes are numerous, among which are 
heat, light, dust, dampness, cinders, brimstone 



HAT FEVER. 23 

matches, gas, cold winds, drafts of air, the 
pollen of plants, grasses, shrubs, trees, etc., the 
odor of certain animals, plants, grasses, trees, 
vegetables and fruits, fumes, perfumes, and 
other emanations. (6), That it is of miasmatic 
origin. (7). That is due to local chronic dis- 
ease of the nasal cavities, and that — except 
when disease of the nasal mucous membrane or 
nasal cavities, exists — the alleged exciting 
causes are inoperative. 

The first, or pollen theory, originated with the 
laity of England, from the circumstance that 
their annual attacks occurred with the ripening 
of grasses and during harvest or hay-making 
time. They therefore attributed their attacks to 
the influence of pollen: hence the terms, ^^Hay 
Fever " and '' Hay Asthma " by which it is gen- 
erally known there. Dr. Elliot son was the first 
writer to use the term '' Hay Fever," which has 
been attached to it since his day. He was led 
to give it the name from the fact that one of his 
patients — an agricultural laborer — observed 
that his attacks were precipitated by inhaling 
the emanations of dried hay. This theory is 
still the most popular one, and is sustained by 
the majority of writers. The careful experiments 
and researches of Dr. C. H. Blackley (second 
edition, 1880), conclusively demonstrate that 
the pollen of various plants stands as a causa- 
tive factor in relation to the annual attacks of 
hay fever, and later experiments of other writers 
verify it, but prove that the pollen plays a sec- 
ondary part only. Flowers have no charm for 



24 HAY FEVER. 

the victim of this disease, for their presence is 
often sufficient to excite a paroxysm of sneezing, 
coughing and asthma. 

That pollen is an undoubted factor in the 
causation of hay fever and its appearance on a 
specified date is well demonstrated and proven 
by Blackley and others, from the fact of the pre- 
cision with which some plants ripen annually, as 
all botanists know. A removal from the locality 
where the irritant exists, to the sea shore, 
mountains or a sea voyage, or a change to any 
place where the pollen of the special irritant is 
not found, gives immunity from the attacks, un- 
less the winds should carry the irritant to the 
new habitation. 

The second theory originated with Helmholtz, 
from his discovery of vibriones, or minute organ- 
isms, in his own nose ; to their presence he 
ascribed the disease from the fact that they 
could be found in the secretions from his nose 
only when sneezing during his attacks, and not 
when free from the disease. Dr. Salisbury, in 
1873, discovered an animalcular organism which 
he termed Asthmatos ciliaris, and considered it to 
be the cause of the disease. This animalcular 
theory has a few advocates, which is largely due 
to the encouragement received from the sup- 
porters of the germ theory. Those that are 
blinded by the supposed scientific glare of the 
animalcular theory, contend that internal treat- 
ment for the relief of hay fever is inefficient, 
and, therefore, that it is incurable by any 
'Apathy " or any means other than by destroying 



HAY FEVER, 2o 

the parasite. It is difficult to conceive by any 
process of reasoning why Sabadilla and other 
medicines, administered internally, high or low, 
can, and ofttimes do prevent, abort or cure , 
many cases in those who sneeze in the tor- 
ments of hay fever, if their nose and eyes wer^ 
paying their briny tribute to the Helmholtzian 
parasite. The presence of vibriones in the nas^l 
secretions can only be accounted for by the 
claim that '' decomposing mucus is always popu- 
lous with this common infusoria." Dr. Morell 
Mackenzie, in his '' Hay Fever, Its ^Etiology and 
Treatment, London, 1884," says: ''It need 
scarcely be said that zealous ' bacteriomaniacs ' 
have, of course, sought for parasitic germs in 
the nasal secretions of those subject to hay 
fever; but although bodies resembling pollen- 
corpuscles have been found [British Medical 
Journal, 1881, Vol. 2, page 18), no specific or- 
ganisms have, so far as I am aw^are, been 
detected. It is almost a comfort in these days 
to find one disease for which the ubiquitous 
bacillus does not appear to be responsible." 

The third theory has many advocates. Among 
these the late Dr. Geo. M. Beard, of New York, 
was one of the earliest and most prominent. 
In his treatise on ''Hay Fever," or "Summer 
Catarrh," in 1873, and in his monograph on the 
same in 1876, he was very pronounced in his 
opinions. But he mistook the effect for the 
cause, in ascribing the origin of the disease to 
the nervous system, for the nervous phenomena 
can be more satisfactority explained as arising 
by reflex irritation from the local affection, and 



2Q HAY FEVEU. 

by systemic disturbance. According to Dr. 
Beard's theory (the nervous), three conditions 
are requisite to the existence of a paroxysm of 
hay fever: (a). Abnormally sensitive nerve 
centres, (b). A hypersesthetic condition of the 
peripheral extremities of the nerves, (c). The 
presence of one or more of the vast number 
of irritants. 

But the disease cannot be of nervous origin, 
else why does it appear at a stated month, day 
of the month, and even, in some instances, at a 
stated hour of the day, and not at other times 
of the year ? There is no other nervous dis- 
ease with which we are acquainted, possessing 
this peculiarity. Nervous diseases occur at any 
and all seasons. 

The fourth theory is incapable of being the 
explanation of its annual recurrence at a definite 
season and generally on a definite day or hour, 
in persons of apparently good health, and free 
from any traces of nervous or other disorders at 
other times of the year. If we may judge by the 
number of writers on hay fever, and other 
diseases, who are ever ready to attribute the 
causes of disease to an idiosyncrasy, without 
further explanation, one would infer that almost 
all diseases were inherent in the system. The 
term " idiosyncrasy " is only a convenient ex- 
pression to cloak ignorance. The words ''con- 
stitutional diathesis " would not have so great a 
significance in the medical world, if we were 
more specific in our investigation of the cause of 
disease. If hay fever is due to an idiosyncrasy, 
it is not a congenital, inherent, or innate 



HAY FEVET?. 27 

idiosyncrasy, and, consequently, tlie disease is 
not hereditary. Of the eighty-one cases re- 
ported by Wyman, we find only four of the 
number whose parents were similarly afflicted, 
which precludes the possibility of its hereditary 
origin. If hay fever be due to an idiosyncrasy, 
it is only an acquired idiosyncrasy due to the 
effects of some previous diseases. In the true 
acceptation of the term, all diseases that are 
said to be due to an ''idiosyncrasy, "or to " con- 
stitutional diathesis," are considered as being 
congenital : hence these terms are not applicable 
to hay fever. The fifth theory includes too much. 
Not one of the irritants named bears a causa- 
tive relation to the disease. The theory that 
light and heat can produce hay fever, is 
completely opposed by the fact that sufferers 
from the affection are usually relieved, or have 
immunity from it, on going out to sea, where 
the sun's rays are more powerful than on land. 
During the hay fever season dust of all kinds is 
composed more or less of various kinds of pollen. 
Gas, odors, fumes, and emanations, produce 
more or less irritation of the nasal cavities, but 
are not sufficient to set up hay fever in one with 
a healthy condition of the nasal mucous mem- 
brane. To one witli a knowledge of the aetiology 
and pathology of hay fever, the sixth theory — 
promulgated by John E. Kippax, M.D., of 
Chicago, in his " Lectures on Fevers." ISS-t, 
page 123, — does not present a single feature 
to commend consideration, or adoption. If 
pollen is a miasm, then another fact is added 
to scientific medicine. 



Chapter IV. 

After consideration of these numerous and 
conflicting theories, it is but natural to examine 
the parts affected for an explanation of its 
causes and phenomena, and to ascertain why 
the inhalation of this diversified " invisible 
nastiness " (as Tyndall very appropriately terms 
it) should produce a common result in persons 
subject to the disease. In the examination of 
the nasal and naso-pharyngeal cavities of a boy 
aged sixteen, to discover the character of a 
catarrh about which he consulted me, I found 
hyperaemia, hyperaesthesia, hypertrophy, the 
mucous membrane denuded of its epithelium, 
and partial stenosis of the nasal cavities. He 
soon thereafter changed his place of residence, 
and, as I afterwards learned, had hay fever the 
following year. An examination of the nasal 
and naso-pharyngeal cavities of cuiy or all hay 
fever victims during the interim of attacks, and 
when in apparent good health, will reveal either 
hypersemia, hypertrophy, hypersesthesia, ulcer- 
ation, exostosis, polypus, deflection of the 
septum, stenosis, or other anatomical or patho- 
logical conditions or peculiarities, or both com- 
bined, with perverted physiological functions, 



HAY FEVER. 29 

showing a local structural or functional disease 
of these cavities, which constitutes the prime or 
latent cause of hay fever. These pathological 
peculiarities and perverted physiological func- 
tions of the parts — organic changes — are the 
result of a neglected or improperly treated 
catarrh, catarrhal fever, repeated colds, or other 
diseases which leave the mucous membranes 
and structures in a sub-acute inflammatory and 
hypersensitive condition, and consequently 
highly sensitive to the action of pollen, dust, 
or other irritants or external influences, and 
upon which the exciting causes operate, and 
develop the disease in question. The action 
of pollen, dust, and other irritants — more espec- 
ially pollen and dust — upon the nasal cavities 
in developing hay fever is almost universally 
conceded, but hay fever has a previously existing 
lesion in the nasal cavities, otherwise pollen and 
other irritants could not induce an attack : hence 
the above-stated cause, a pre-existing diseased 
condition of the structures and functions of these 
cavities, is the jyredmj^odmj cause, and pollen 
and other irritants, the exciting cause. Conse- 
quently, as exciting causes, they play a secon- 
dary role. The fact of this disease being more 
prevalent in localities where catarrhal diseases 
prevail, goes far to substantiate the above state- 
ment. 

The fact that, to the knowledge of the hay 
fever sufferer, there are generally no after-elf eets 
remaining from an attack of hay fever, or any 
objective or subjective phenomena by which the 



30 BAY FEVER. 

physician could discover any lesion other than 
the pre-existing local chronic disease, precludes 
the possibility of any pollen poisoning— first 
mentioned by Dr. Marsh, and generously ac- 
cepted by a few others — and demonstrates that 
pollen, dust, and other irritants are mechanical 
and not toxicological in their effects. 

There is no peculiarity of constitution, form, 
or condition, observed in those who are subject 
to this disease other than the pre-existing nasal 
disease, anatomical peculiarities, and consequent 
perverted physiological functions mentioned. 
The " individual aptitudes," " predisposition," 
'^ individual or special susceptibility," ''consti- 
tutional peculiarity," ''idiosyncrasy or consti- 
tutional diathesis," and other synonymous terms 
used by various writers as explanatory of the 
causes of hay fever, can all be explained by 
reference to the pre-disposing cause — tlw local 
chronic disease. The majority of these writers 
fail to explain the origin or cause of the special 
susceptibility, etc., which they so modestly and 
satisfactorily accept. The cause of the deranged 
state of the nerve centers, or neurosis, of which 
many so assuringly write, is not explained by 
any of them. By an explanation we could bet- 
ter comprehend their theory of its cause. But 
it becomes clear when we consider that the sys- 
temic disturbance, such as asthma, the implica- 
tion of the eyes, ears, bronchi and lungs, and 
the nervous phenomena, are the result of the ir- 
ritation of the diseased tissues in the nasal 
cavities, which is reflected to distant parts and 



HAY FF/VER. 31 

organs, causing in them a fluctionary hyper- 
emia, produced through the correlating func- 
tion of the sympathetic gangha connecting these 
different regions with the nose. 

Dr. Daly, in an article on the ''Eelations of 
Hay Asthma and Chronic Naso-Pharyngeal Ca- 
tarrh," [Archives of Laryngology, Apr. 1882, vol. 
3, p. 57), reports the histories and cure of three 
patients, who were sufferers from hay fever and 
hay asthma, for six, fifteen and twenty-one 
years ; two of which were cases of hypertrophy 
of the nasal mucous membrane, and one a case 
of polypus; the cure in each case being obtained 
by removing the morbid condition in the nasal 
cavities. Dr. F. H. Bosworth, of New York, 
says: *'0f the sixty cases of hay fever which I 
have personally examined, I have seen none in 
which there was not notable obstructive lesion 
in the nasal cavities." 



Chapter V. 

Patliology. — The number of haj^ fever sub- 
jects in the United States is probably four times 
that of our standing army. Information rela- 
tive to this disease is eagerly sought by this vast 
army of sufferers if it offer a ray of hope of re- 
lief or cure. That hay fever — so-called ■ — is a 
morbid entity can be demonstrated by an in- 
vestigation into and knowledge of its- aetiology 
and pathology. Sir. Morell Mackenzie, in his 
^' Hay Fever, its .Etiology and Treatment, 1884," 
says in relation to the pathology of this disease : 
''Hay fever leaves no permanent structural le- 
sion behind it, and cannot therefore be said to 
have any pathology." But he is wrong. A dis- 
ease can have a pathology without leaving a per- 
manent structural lesion behind it. As has been, 
and will hereafter be shown, hay fever has its le- 
sion in the nasal cavities, and conseqently has a 
pathology : i. e,, there is a permanent diseased 
condition of the nasal cavities — the result of 
other diseases — which, being acted upon by cer- 
tain irritants, produce the disease. 

The want of definite knowledge in the past 
concerning the aetiology and pathology of this 
disease has not been from want of patient, care- 



HAY FEVER, as 

ful, and close observation or painstaking re- 
search to ascertain its causes, but from the fact 
that its presumed causes have been studied in- 
dependently, that their relation to the tissues in 
the nasal and the naso-pharyngeal cavities have 
not been taken into consideration, and that the 
diseased condition of these tissues, which render 
them susceptible to various influences, has been 
entirely overlooked. In the examination of the 
various articles and more or less elaborate works 
on hay fever, there is no intimation of any inves- 
tigation into the objective phenomena of the nasal 
or naso-pharyngeal cavities as to the existence 
of any localized diseased condition or anatomi- 
cal peculiarities that might predispose to the 
aifection, previous to the articles of Drs. Daly, 
Eoe, Sajous, Harrison, Allen, and J. N. Macken- 
zie. Hay fever patients are all alike in present- 
ing certain anatomical peculiarities or pathologi- 
cal conditions of the nasal cavities, or both 
combined, among which are : obstruction by 
deflection of the septum (either congenital, or 
acquired by disease or injury), sometimes unusual 
prominence of the inferior turbinated bones, 
stenosis, or complete closure of one or both 
cavities, hypertrophy of the soft parts or bones, 
polypus, exostosis, or other diseased condition 
of these cavities. The tissue covering the 
inferior turbinated bones and lower part of the 
septum is a highly vascular, erectile tissue, which 
is under the control of the vaso-motor nerves, 
and is highly sensitive in local impressions, as 
well as to other impressions in other parts of 



34 HAT FEY En, 

the body. The effects of a cold in the head, or 
of a draft of air striking the body will, in some 
instances, cause this tissue to become engorged 
and thus occlude one or both nostrils. The en- 
gorgement of this tissue as a result of a draft of 
air, or sudden chilling of the body, etc., causes 
the distressing sensations arising from and ac- 
companying a cold in the head. A remaining 
engorged, sub-acute inflammatory, or hyper- 
sensitive condition of the tissue covering the 
nasal cavities — a rhinitis — as a result of the 
above operative causes, is irritated by the con- 
tact of pollen and other irritants, which develop 
a rhinorrhoea, and also what is popularly but 
erroneously denominated hay fever. An inflamed, 
turgescent or hyperaesthetic condition of this 
tissue — although slight and not sufficient to cause 
any special annoyance, or attract the attention 
of the patient' — may, through atmospheric and 
other influences, increase its susceptibility to 
irritation in a marked degree, or result in per- 
manent hypertrophy, and consequently nasal 
stenosis. 

There is an intimate connection between the 
nervous supply of the nose, eyes, ears, throat, 
bronchi and lungs. The irritation reflected from 
tissues of the nasal cavities through the sympa- 
thetic nerves to other parts and organs, is the 
excitor of the varied and distressing symptoms 
and conditions experienced by hay fever victims, 
among which are hay asthma. 

If the lesion of hay asthma is traceable to 
the nasal cavity, it is reasonable to suppose that 



I/AV FEVER. 35 

the lesion of other forms of asthma may l>e 
traceable to a diseased condition of this cavity. 
Such has been the result of my investigations in 
cases of asthma. The importance of an unob- 
structed nasal passage, free nasal respiration, 
and a healthy condition of the nasal mucous 
membrane can only be realized and appreciated 
when one attempts to eat, drink, sleep, or talk 
with the cavities closed. 



Chapter VI. 

Diaguosis. — Hay fever may be mistaken for 
a cold in the head, catarrh, influenza, catarrhal 
fever, ophthalmia, acute bronchitis, or asthma. 
In hay fever we have itching of the nose, eyes, 
ears, mouth, throat and skin, paroxysmal and 
violent sneezing, profuse bland or acrid discharge 
from the nose, occlusion of the nares, an in- 
flamed condition of the eyes ; headache, fever, 
spasmodic cough, asthma, a specific date for its 
annual recurrence, which visitations are out of 
the seasons of ordinary colds, catarrh, influenza, 
etc. It is of long duration and great severity. 
There is no predisposition, as a rule, to other 
diseases, and the combination of symptoms and 
conditions are not common to any of the above 
diseases. A careful study of its symptoms, 
aetiology and pathology, will prevent its being 
confounded with any other disease. 

Prognosis. — The prognosis is favorable. A 
removal from the exciting causes gives immunity 
from the affection. The catarrhal and asthmatic 
conditions seldom, if ever, lead to grave results, 
or to permanent organic changes. No matter 
how severe the case may be, the symptoms finally 
disappear in all but rare instances, and the pa- 
tient recovers health in the months of perfect 



HAY FEVER. 37 

immunity. It does not appear to shorten life. 
It has heretofore been regarded as the most 
obstinate and, to. a great extent, one of the in- 
curable diseases, but the discovery of its lesion 
being in the nose has made prognosis favor- 
able in all cases, for just so far as we can cure 
this pre-existing nasal disease, just so far can we 
cure hay fever. The co-existence of great debility, 
pregnancy, pulmonary or bronchial affections, 
and grave constitutional difficulties modifies the 
prognosis. 

Sanitary Eesorts. — The only places to which 
hay fever victims, as a rule, can resort with 
benefit or immunity, are those where vegetation 
does not exist, as on the ocean, or where the 
seasons are so short vegetation does not ripen, 
as in high mountain regions, or on islands, show- 
ing conclusively the result of the inhalation of 
substances arising from Summer's or Autumn's 
growth. Some hay fever subjects are only sus- 
ceptible to a special irritant ; these have immun- 
ity by removal to a district where this irritant 
does not exist, or is not carried by the winds. 

The principal and favorite hay fever resorts in 
the United States are the White Mountains, 
Catskills, Adirondacks, AUeghanies, Lookout 
Mountain, Eoane Mountain, the Kocky and 
Sierra Nevada Mountain country. Lake Chau- 
tauqua, the shores of Lake Superior, Put-in 
Bay, Colorado Springs, Col., Hot Springs, Ark., 
Fire Island, the Island of Mackinaw, Cobb's 
Island, and Brigantine Beach, New Jersey. 

Some of the principal hay fever resorts of 
Europe, are : The Highlands of Scotland, the 



38 HAY FEVER. 

mountainous districts of Wales, the rocky At- 
lantic coast of Ireland, and the mountains of 
Switzerland. These hay fever resorts give im- 
munity, by virtue of the rare and pure atmos- 
phere, wherein pollen, etc., does not exist, and is 
not carried or found floating, in contradistinction 
to the humid atmosphere of the habitat of the 
victim, wherein all the various irritants float, 
and other exciting causes operate. A sea voy- 
age gives entire immunity from the disease. All 
hay fever subjects do not alike receive immunity 
from the disease. Dr. J. C. Morgan tells us that 
" Hydrogenoid patients do badly at the sea-shore, 
but Long Branch, on the New Jersey coast, has 
a special reputation as a sanitary resort for hay 
fever subjects, having no upland vegetation, 
and being separated from the mainland by five 
miles of salt bay." The case of a lady was 
brought to my notice, who had been a victim of 
hay fever for several years, who visited Hot 
Springs, Ark., for three consecutive years, at 
about the usual time for the attack, and remained 
until the hay fever season was past. She has 
had entire immunity from the disease since. 
Some physicians claim that there is an element 
of the practical in the geographical feature of 
the disease in that it enables them to direct their 
patients where they may expect to find immunity 
from their attacks. To a homoeopathist with a 
knowlege of its aetiology, pathology, the proper 
local and general measures for removal of the 
pathological condition, and the proper similimum, 
there is no necessity for such consolation, or of 
making exiles or refugees of hay fever patients. 



Chapter VII. 

Treatment. — This disease has heretofore been 
considered one of the most difficult and refractory 
to deal with and the treatment generally unsat- 
isfactory. 

Phoebus gives a long list of remedies that have 
been unsuccessfully employed to combat it, and 
Zuelzer, in Ziemssen's Encyclopedia, after giving 
a history and description of the disease, dismisses 
the consideration of its treatment, with the state- 
ment that ''treatment is powerless against it." 

From the diversified internal medication rec- 
ommended by writers of other schools, there is 
nothing to offer, on account of the results of the 
treatment having been unsatisfactory. It con- 
sists mainly of tonics, sedatives, alteratives and 
nervines. 

With many, a favorite local application has 
been to irrigate the nasal cavities with a solu- 
tion of Quinine, gr. j, orij, to water sj, two, three 
or more times daily. This was first recommended 
by Helmholtz. It has proved of but little if any 
benefit. The good effect, if any, is attributable 
to the solution washing away the corpus deUcti 
mechanically, rather than by any parasiticide 
action. The various injections and insufflations 



40 HAY FEVEU. 

recommended have been of no permanent bene- 
fit and in many instances have proved injuri- 
ous. Sir Morell Mackenzie, (Hay Fever, 1884, 
page 22), says: '^I trust very Httle to lo- 
cal measures in the treatment of hay fever, but 
when there is profuse secretion with an excessive 
tendency to sneeze, the inhalation of strong 
Ammonia salts often gives great relief." Many 
appliances and devices are recommended for the 
comfort of the patient during an attack, but none 
of them equal prompt and well directed treat- 
ment towards the removal of the cause. 

No experiments since those made by Blackley 
have been as thorough as his. They were then 
comparatively satisfactory from an setiological 
point of view, but did not suggest a successful 
plan of treatment. 

Homoeopathic literature records but few abso- 
lute cures. Leading writers of our school speak 
with indifference in relation to its aetiology, 
pathology and treatment. 

There has been but little concurrence in the 
various articles written in relation to treatment. 
The internal treatment suggested has been main- 
ly empirical, and has depended largely upon the 
fanciful doctrine of signatures, especially the in- 
dications for the guidance in the choice of the 
remedy, which has often been colored to suit 
the views of the writer in reference to some fav- 
orite remedy or supposed specific. This lack of 
unanimity is attributable to the fact, that, until 
recently, the aetiology and pathology have been 
but imperfectly understood. 



HAY FEVEB. 41 

Many cures of hay fever are reported, which, 
upon inquiry in after years, it is learned that 
the attacks recurred each succeeding year, and, 
in many instances, the treatment that once re- 
He ved was of no avail in succeeding attacks. 
These are not absolute cures ; they are only a 
partial or temporary cure. An absolute cure 
can only be effected by a removal of the prime 
cause — chronic nasal disease — which prevents 
the susceptibility to the action of pollen and 
other irritants, and consequently a recurrence 
of attacks. The treatment is necessarily a 
varied one, and depends upon the individuality 
of each case. It is sometimes of service to use 
locally the same remedy that is administered 
internally, but generally in a more crude form. 
This local remedy is used by inhalation, by hot 
or cold sprays, but generally should be applied 
directly to the diseased tissues. It is hardly 
necessary to specify the local treatment other 
than in a general way. When a polypus is the 
cause — as it has been found to be in a few in- 
stances — a removal by instruments, electricity, 
cauterization either by the galvano-cautery or 
acids, or, as has been accomplished in some in- 
stances, by internal medication in connection 
with a low dilution or trituration of^tlie same 
medicine administered locally. This has been 
accomplished by the use of Thuya, Sanguinaria 
canadensis, Teucrium and a few other medicines 
in cases of polypus of various parts. 

In the Louisville Medical News, Aug. 22, 18S5, 
page 115, Dr. W. Cheatam, says: '* Some few 



42 HAT FEVER. 

may be relieved by curing an existing nasal ca- 
tarrh." 

Among the pathological changes, simple 
chronic rhinitis is the condition most common- 
ly met with when examining a patient during 
the intervals between the attacks, when all out- 
ward manifestations of the disease have disap- 
peared. 

Those who have once suffered from chronic 
rhinitis generally enjoy immunity from common 
catarrh. For a removal of chronic rhinitis it 
is essential to begin treatment as soon as de- 
tected. Prominent among the indicated reme- 
dies for this condition are Sanguinaria canaden- 
sis, Banguinaria nitrate, Kali hydriodicum. Kali 
bichromicum, Cinnabaris, Sinapis nigra, and 
some of the mercurial preparations, especially 
Mercurius protoiodatus. 

A Vaseline spray, both during the attacks of 
hay fever and during the interim of them, is 
both soothing and beneficial. It may be neces- 
sary during the attacks to use other adjuvants : 
i, e., spraying with a weak aqueous solution of 
Boracic acid, puncture of the swollen portions 
of the membrane with a narrow knife blade, 
Cocaine, the galvano-cautery, or, in some in- 
stances, acids. In using the knife, galvano- 
cautery or acids, we must not be unmindful that 
these mechanical and operative measures must 
be used with a considerable degree of caution, 
as extensive tracts of cicatricial tissue may be- 
come the seat of more serious disease than hay 
fever. In the Journal of the American Medical 



HAY FEVER . 43 

Association, Feb. 6, 1886, Dr. S. S. Bishop says: 
''The new surgical treatment of hay fever, 
which consists of cauterizing the sensitive areas, 
is too recent to have afforded permanent results. 
Not wishing to prejudice against the operation 
those to whom it might prove beneficial, I will- 
ingly part company with this phase of the sub- 
ject. But I cannot do so with fidelity to the 
profession and to this class of patients without 
warning them of possible consequences. This 
treatment may precipitate paroxysms of verita- 
ble asthma. In fact, two applications of the 
galvano-cautery, under Cocaine anaesthesia, have 
superinduced true asthma without curing the 
hay fever." 

With the chronic rhinitis there may exist a 
tendency to frequent or permanent turgescence, 
hypersesthesia, fiuctionary or permanent hyper- 
trophy, adenoid vegetations, tumors, a deviated 
or thickened septum, stenosis, anatomical pecul- 
iarities, either congenital or acquired, or other 
organic changes. It is useless to attempt a re- 
moval of true or permanent hypertrophy by in- 
ternal medication. It may aid in some instances, 
but the main reliance should be upon the cold 
wire or Jarvis snare, the galvano-caustic snare, 
galvano-cautery, or caustic acids, i. c, Chromic, 
Glacial- acetic and Nitric. It is in this hyper- 
trophic condition that we are more especially 
justified in the use of the galvano-caiitery, gal- 
vano-caustic snare and caustic acids, but even 
then the patient should be imder close surveil- 
lance that we may be sure of the reduction of 



44 BAY FEVER. 

the redundant tissue, and to correct any com- 
plication that might arise from the cautious use 
of the above measures. Following these opera- 
tive procedures, it is generally advisable to use 
the Vaseline spray. Nitrous-oxide gas is a con- 
venient anaesthetic in using the galvano-cautery. 
Chronic hypertrophic nasal catarrh, and hyper- 
trophic rhinitis are frequent causes of asthma 
and hay asthma. This can be demonstrated by 
their removal, when there will be no recurrence 
of the asthma. 

Adenoid vegetations or adenomata at the 
vault of the pharynx can be removed by the 
properly selected homoeopathic remedies, in con- 
junction with proper cleanliness and attention to 
diet and hygiene. Where this condition is ex- 
tensive, it is essential to resort to operative 
measures similar to those in the removal of hy- 
pertrophy. The attendant catarrhal condition 
should receive prompt attention and constitu- 
tional treatment be given with the object of pre- 
venting a recurrence of the growths. 

The Hydrochlorate of Cocaine is a valuable 
adjunct in the treatment of hay fever. A four 
per cent solution is the strength commonly 
used, but it may be used of a varying strength. 
It will not cure, but it palliates and temporarily 
checks the ravages of the disease by the local 
insensibility it produces, and partly by the con- 
traction of the capillaries it induces, lessening 
the hyperaemia and rendering the mucous mem- 
brane temporarily insensible to the action of 
pollen and other irritants. It will arrest the 



HAY FEVER. 45 

bronchial catarrh and asthma accompanying this 
disorder. If used in the early stages, the sneez- 
ing stage or in mild cases, where the main or 
only feature is sneezing, it checks the disease 
temporarily, enables hay fever refugees to re- 
main at home and lessens the tendency to com- 
plications. Its continued use, whenever any 
irritation has been set up, has given ma.ny per- 
sons almost entire relief from the annoying and 
distressing conditions attendant upon the dis- 
ease. As a palliative it acts like magic, and for 
prompt but transient relief, no other local agent 
equals it. Dr. DaCosta has found it useful in 
a number of cases. It should be applied be- 
fore using the galvano-cautery and other opera- 
tive measures. It is used from one to three 
times per day, and in extreme cases oftener, but 
generally one application a day suffices. The in- 
troduction of Cocaine tablets within the nasal 
cavities once or twice a day, is a convenient 
mode of using it. Some patients are highly 
susceptible to its influence and cannot tolerate 
its use, at least only at long intervals. Serious 
results have attended its use, especially when 
used so often that the absorption of a large 
quantity has produced physiological and even tox- 
ical effects. The manner of using it is by means 
of absorbent cotton and cotton-holder ; or a cam- 
el's-hair brush ; or a small atomizer, spraying 
the entire nasal cavity; or, by injection of a few 
drops into each nostril ; or, by having the patient 
in a recumbent position and using a common 
dropper, having the patient spit it out should 



46 HAT FEVER. 

any get in the mouth or throat. Care should 
be taken to have the parts first cleared of mu- 
cus, which enables us to get a quicker action 
of the drug. It has both a primary and sec- 
ondary action. By its primary action we have 
anaesthesia and anaemia, causing total but tran- 
sient insensibility and a paleness of the mem- 
brane, with some retraction. The secondary 
effects are swelling and hyperaesthesia of the 
parts, even to a greater degree than before its 
use, even to the complete closure of the nasal 
cavities for hours. 

In one case that came under my observation, 
a gentleman who was a confirmed hay-fever suf- 
ferer, whose attacks soon developed into a severe 
asthma, kept himself entirely relieved from the 
annoying symptoms and asthma by one applica- 
tion daily of the Cocaine, or whenever any irri- 
tation had been set upon in the nasal cavities. 

In giving therapeutic indications it will be 
my aim to class the medicines in the order of 
their prominence as observed by myself, and by 
others who seem to have a true conception of 
the therapeutic treatment, and to include there- 
after reported cures made by the remedy. 



Chapter VIII. 
Therapeutic Indications. 

Naphthaline— Dr. Von Grauvogl discovered 
by provings on the healthy, and confirmed by 
cHnical experiraents, the use of this remedy in 
emphysema pulmonnm. He claims that " the 
violent asthmatic attacks are ameliorated im- 
mediately, and soon disappear entirely." He 
gives it two or three times a day, and not often- 
er than every two hours. He recommends that 
*^the administration should be interrupted oc- 
casionally, for eight days, but as soon as the 
improvement ceases, or a return occurs, the 
Naphthalin must be taken as before." He also 
claims that '^ beneficial results arise not only in 
the usual chronic emphysema, with bronchial 
catarrh, which exists in the lungs of buglers, but 
also in the emphysema, in consequence of the 
so-called bronchial asthma, without bronchial 
catarrh, which arises from abnormal innervation 
of the vagus." 

This remedy is applicable to more cases of 
hay fever, and to more forms of it, and better 
results are obtained from its use in all stages, 
than from any other drug. As a prophylac- 



48 BAY F^VEE. 

tic, a dose of the 2x, or 3x trituration, either in 
powder or tablet, if given three times a day, will, 
in many — though not in all — instances, give 
immunity from an attack. It is in those cases 
in which previous attacks have been slight, that 
it will prevent an onset of the disease. In rose- 
cold I have never given any other remedy, and 
have cured every case, though the number is 
not great. 

On May 6th, 1885, I received the following 
note from Mrs. C — : ''I am in torture with 
rose fever ; great irritation of the lining mem- 
brane of nostrils and lips, with constant run- 
ning of water from the nose, with feeling of 
having inhaled pepper. Constant sneezing. 
Eyes inflamed and painful. Entire head hot 
and inclined to ache. Send something to re- 
lieve me." I prescribed Naphthalin, 2x trit., 
every hour. On May 8th, the patient called at 
my office for more medicine, and wanted to know 
what that medicine was that gave her so much 
relief. She said she had had rose fever every 
year for twelve years, and had been treated by a 
number of physicians with but little relief at any 
time, until she had taken treatment from me. 
On May 11th she called again. She said she 
was cured, but, as she was going out of the city, 
she wanted another prescription of the same 
medicine to take with her to use in case of a re- 
turn. On May 29th she called at my office 
again ; she had had no return of the disease. 
( Eeported in American Homoeopathist, Vol. II, 
Dec. 1885, page 354.) 



HAY FEVER. 49 

I had not seen this patient again, until March, 
1888, when I learned there had been no recur- 
rence of the attacks. 

I first prescribed this medicine in 1879, in a 
case of hay fever which I had failed to relieve 
with other medicines. The Ix trit. was given 
every four hours. Four powders cured, and gave 
immunity from its recurrence. In 1880, six 
powders gave a like result. In 1881, there was 
no attack. In 1882, the patient changed his oc- 
cupation, which required constant traveling. He 
had a recurrence of the disease. The same 
medicine, 2x trit., cured in a few days and there 
has been no recurrence since. 

In the June issue of the f7. S. Medical Investi- 
gator, Vol. XXL, 1885, page 299, 1 introduced to 
the profession the use of this medicine in hay 
fever, and related the coincidence that led to its 
use. Since that time, I have had the gratifica- 
tion of having many physicians bear testimony 
to its successful use. 

In the following August issue of the same 

journal. Dr. W. C. D , Oakfield, Wis., in 

relating his ** experience with Naphthalin," says : 
*'I have a case of hay fever here in which Naph- 
thalin, 2x trit., did a splendid thing. A lady 
who has been troubled for the last eight years, 
had found no relief. I gave her five powders and 
she reported herself cured, something ditterent 
than she is usad to, as she now sleeps all night 
and feels splendid. " 

In the following October issue, Dr. W. Wad- 
dell, Wauseon, Ohio, reports fine results from 



50 HAY FEVER. 

the use of Naphthalin 2x trit., in hay fever, giv- 
ing five two-grain powders, which cured every 
case, where he had tried other remedies and 
failed. 

In the December issue. Dr. 0. P. Barden, Tio- 
ga, Penn., says : *' Dr. B. F. Grant, of Bath, New 
York, who was a sufferer from hay fever, received 
prompt relief from Naphthalin Ix or 3x trit. " 

In the October issue of the Southern Journal 
of Homoeopathy, Vol. V., 1885, page 87, 1 reported 
the cure of a case of acute catarrh with Naph- 
thalin when other remedies had failed. 

Next in order was the testimony of the vener- 
able Dr. A. E. Small, in his "Systematic Treatise 
on the Practice of Medicine, " 1886, page 775, in 
the following words : 

" Naphthalin in hay fever. We have had 
some delightful experience in the use of this 
remedy in hay asthma the present season ; sev- 
eral cases were relieved or cured in the course 
of one week, with the 2x trit. " 

Besides these, others have testified to its effica- 
cy by personal letters, clinical cuUings, and 
through the journals, but the best testimony of 
all comes from Dr. F. F. Laird, Utica, New 
York, in an article on " Naphthalin, " read be- 
fore the Homoeopathic Medical Society of the 
State of New York, Feb. 15th, 1888, and pub- 
lished in the North American Journal of Homoe- 
opathy, March, 1888. The portion of it under 
"Respiratory Organs,'' relating to hay fever, I 
herewith copy : 

1. "Hay Fever, — For this obstinate malady 



HAY FEVER. 51 

it is facile princeps. Dr. Small and many others 
in the homoeopathic ranks have here testified to 
its wonderful efficacy. ^ It almost never fails, ' 
is an assertion to which the writer can truth- 
fully and emphatically add his verdict. While 
it seems to benefit all cases of this strange neuro- 
sis, (?) it is especially adapted to patients who 
experience more or less asthmatic symptoms. I 
may safely say that Naphthalin is to " hay asthma " 
what Aconite is to synochial fever, as near a specific 
as anything in medicine can he, 

** During this summer and fall I have treated 
eighteen cases of hay fever with this drug alone, 
and with the most satisfactory results. Two 
cases deserve to be quoted as exhibiting the typi- 
cal patient. 

"Case 1. — E. L., aged 46, nervo-bilious tem- 
perament, has suffered for nineteen years with 
hay fever, which put in an appearance regularly 
on the 14th of August. It began with dull fron- 
tal headache and sense of malaise, followed in 
from 24 to 48 hours by fluent coryza, excessive 
sneezing, injection of conjunctivae and most un- 
bearable itching of the eyelids. During the first 
week this condition gradually increased until 
the nose, eyelids, and, in fact, the whole face, 
became so swollen as to resemble the counte- 
nance of Sullivan's antagonist after a prize fight. 
During the second week, the inevitable asthma 
added to his misery. Night after night he suf- 
fered from as intense dyspnoea as I ever wit- 
nessed, the lips and even the finger nails becom- 
ing blue ; while all through the day his wheezing 



52 ITAY FETEB. 

breathing could be easily heard in an adjoining 
room. Ipecac, Arsenicum, Kali iod., Sabadilla, 
Aralia, were all faithfully tried, together with 
many other remedies of less note. Hypodermic 
injections of Morphia and Atropia gave him his 
onh' relief in the paroxysms of asthma. A trip 
to the White Mountains put an end to the trouble 
for 1886. During last winter my attention was 
first called to Naphthalin, and immediately the 
above case came to my mind as most appro- 
priate for its use. On August 1st of this year I 
began giving one tablet of the 2x trituration three 
times a day, to test its powers as a prophylac- 
tic. August 14th passed without any sign of 
hay fever for the first time in nineteen years, I 
seem to hear the skeptic suggest that ' He 
wouldn't have had it any way ! ' So the patient 
began to think. He therefore stopped using the 
drug for a week, and on caine his hay fever. On 
resuming the remedy the symptoms at once 
subsided. 

'' This fact illustrates a point which I wish to 
thoroughly impress upon your minds, namely, 
tJie necessity of continidng the use of tlie drug dioring 
the ivhole time that the disease generally lasts. Like 
quinine in malaria it prevents its manifestations 
without stamping out its cause. 

'' Case 2. — F. W. T., clergyman, at about 50, 
lymphatic temperament, a victim to hay asthma 
for 14 years, was frequently compelled to give 
up his pastorate for several weeks and seek the 
mountains for relief. This year he came to me 
in June to know if anything could be done in 



HAY FEVER. 53 



o 



the way of prevention, his old enemy havin 
just commenced operations. He had but recently 
moved to the city in the hope of avoiding this 
pest. Naphihalin 2x was administered, and in 
tivejity-foiir hours he was j'^ejfectly free from Ids 
trouble, and has so continued up to the joresent icrit- 
ing, 

"In cases presenting marked tumefaction of eye- 
lids and nose, ivith very excoriating lachrymation and 
coryza, Naphthalin cerate locally is a valuable 
adjunct to the treatment ; while in marked ir- 
ritability of the throat and in the asthma, the 
application of a two per cent spray will be found 
very useful. " 

I have also learned that to get beneficial re- 
sults from the use of Naphthalin, it must be 
continued at longer or shorter intervals during 
the hay fever season, and its use continued there- 
after in many cases, for the purpose of removing 
the chronic rhinitis, which it has done for me in 
a few instances. I do not think that, ''like 
Quinine in malaria, it prevents its manifestations 
without stamping out its cause, " but, that it 
frequently stamps out the cause. If it does not 
do so entirely while taken during the hay fever 
season — for the exciting cause is present, ever 
ready to renew the attack — it will accomplish 
the desired purpose in some cases by its contin- 
ued use thereafter, when it should be given in a 
higher attenuation. 

From the clinical use of Naphthalin I am led 
to believe it to be a left-sided remedy, and its 
action more pronounced in the left than in the 



54 HAY FEVER. 

right lung. In Naphthalin, we have a sovereign 
remedy in emphysema, asthma, hay asthma, 
hay fever, acute and possibly chronic catarrh, 
and I believe in chronic rhinitis. It should be 
well proved. AVe should not forget that true 
hypertrophy and other organic changes and an- 
atomical peculiarities preclude the possibility of 
a cure by internal medication until these are 
corrected by operative procedures. 

Sabadilla. — This medicine has been recom- 
mended by some writers as a prophylactic, and 
some cures have been reported from its use, but 
I have failed to learn whether any of the cures 
were permanent. Dr. Small says that *'Dr. E. 
M. Hale has succeeded in aborting several cases 
of hay fever with Sabadilla." 

It is of excellent service in relieving excessive 
sneezing, fluent coryza and lachrymation. 

Its therapeutic indications are : Great irrita- 
tion and itching of the pituitary membrane, with 
violent paroxysms of sneezing; copious coryza 
and lachrymation; lachrymation when in the 
open air ; when looking at a bright light ; when 
coughing or yawning ; frontal headache ; redness 
of the margins of the eyelids ; dryness of the 
mouth without thirst ; dry, spasmodic cough ; 
cough worse on lying down ; sensitiveness to 
cool air; agitated, unrefreshing sleep. Dr. 
Bayes has used it with marked success. 

Dr. Hawkes (Clinique, Vol. I, 1880, page 95), 
reports the cure of a case of rose cold of three or 
four years' duration, with Sabadilla 200 in about 
three days, with the following symptoms : 



HAY FEVER. 55 

'' Burning stinging in the bridge of the nose, 
with a full, distended feeling ; complete obstruc- 
tion of the nose, so that he could breathe only 
with his mouth open ; much sneezing, with pro- 
fuse discharge of a bland, watery, very thin 
mucus ; persistent, almost voluptuous itching and 
tingling of the alae nasi at their junction with the 
lips ; sneezing much worse indoors than outside ; 
breathing much easier outdoors ; better in every 
way outdoors ; nose swollen and red ; eyes watery 
and weak looking. Commenced improving next 
morning after taking medicine." In reply to 
my letter of inquiry of Sept. 21st, 1887, Dr. 
Hawkes said : *' In the case of rose cold referred 
to, there was no return of the symptoms, to the 
best of my knowledge and recollection." 

Arsenicum iodatus. — This remedy has been 
recommended as a prophylactic. The prophy- 
lactic power of a drug lies in its ability to so 
affect the organism as to render it proof against 
contagion, or to remove a pre-existing diseased 
condition, and predisposing cause, and render 
it innocuous to an exciting influence. No remedy 
up to the present time, has been so much in 
general favor with the profession as this one. 
Dr. E. M. Hale considers it to be the nearest to a 
specific for hay fever that we now possess. It is 
indicated in cases in which there is a malarial 
cachexia; in persons of a pale, delicate complex- 
ion, prone to glandular enlargements; itching 
and irritation in the mouth, eyes, ears, nose and 
throat ; burning sensation in the nose and 
throat; excessive sneezing; fluent coryza, the 



56 EAT FEVER. 

discharge being thin and acrid, the acridity be- 
ing pronounced ; chilliness ; flushes of heat ; 
puf&ness of the face and eyelids ; eyes and nose 
red; rawness and dryness of throat, with 
hoarseness and asthmatic breathing, the diffi- 
cult breathing being worse in the morning after 
meals, and after midnight ; prostration ; thirst. 

Dr. Blackley, ^ Hay Fever," second edition, 
1880, page 252), says: ''Of all the remedies I 
have had an opportunity of testing, I must give 
the palm to the Iodide of arsenic for its prophy- 
lactic properties in the early stage of hay fever, 
both in my own case and in those of other pa- 
tients." 

In a personal letter, Dr. 0. P. Barden, of 
Tioga, Pa., reports good results with this reme- 
dy, in the treatment of several patients who had 
previously suffered from hay fever for two or 
three months each season. The indications for 
his guidance were as heretofore given. He says : 
*' I find Arsenicum iodide an excellent remedy 
for catarrhal troubles." 

Kali hydriodicum. — Frequent sneezing, flu- 
ent, acrid coryza ; rawness and burning in the 
nasal and respiratory passages ; swelling and 
redness of the nose ; aching pain and throbbing 
in the frontal sinus ; general aching ; corrosive 
lachrymation ; purulent discharge from the eyes,- 
with swelling or oedema of the eyelids ; oppres- 
sion of breathing; hoarseness; violent, suffo- 
cative cough ; profuse, white, frothy or stringy 
expectoration; choking sensation on awaking; 
wheezing breathing. 



HAY FEYEJL 57 

Dr. J. H. Lowrey, Neola, Iowa, reported to 
me, about two years ago, the following case: 
" Incessant sneezing for an hour or more every 
morning on rising ; aching, heavy, pressing pain 
between the eyes ; lachrymation when sneezing ; 
at night the nose became stopped up ; it feels 
sore to the touch. This trouble had appeared 
two years consecutively at the same date. Kali 
hydriodicum Ix trit., one powder every four 
hours, cured in a week, and there was no yearly 
return of the attacks." 

In the l<!ew York Medical Gazette^ October 8th, 
1870, W. C. Eoberts, M.D., vice-president New 
York Academy of Medicine, says : '^ If there were 
any truth in the simUia similibus doctrine, and 
any virtue in infinitesimal doses, Hydriodate of 
potash ought certainly to prove efficacious ; for 
once in my life, and only that once, I saw it 
produce in a man as bad a ' crying cold ' as I 
ever had at any period of my autumnal catarrh. " 

Aralia racemosa. — The venerable S. x\. 
Jones, M.D., proved this remedy on himself, and 
to him are we principally indebted for our knowl- 
edge of its pathogenetic effects. He is a sufferer 
from asthma, and a paroxysm came on after 
taking the remedy, but he claims it was very 
different from his usual attacks, in that it re- 
sembled hay fever. In this complaint and sim- 
ilar suffocative coughs. Dr. Jones has found it 
very beneficial. He relates a case of hay asthma 
cured by this remedy, in which the characteris- 
tic symptoms were : Yearly attacks of suffoca- 
tive catarrh, with e:^treme sensitiveness to a 



68 RAY FEYEB. 

draught, the least current of air causing a violent 
fit of sneezing, accompanied by a copious, wa- 
tery, acrid discharge from nostrils and posterior 
nares. Head felt stupefied from great loss of 
fluid, of a watery, transparent character, of an 
acrid, salty taste, excoriating the nostrils, pos- 
terior nares, and fauces. Waking at night with 
terribly impeded breathing, which necessitated 
immediate rising, with inability to lie down un- 
til nearly morning. During this time, sneezing, 
spitting, and blowing his nose would keep him 
busy. Bending forward, elbows on knees, eased 
the asthma very soon. Walking up stairs pro- 
duced an aggravation. Inspiration was more 
difficult than expiration. When the coryza 
would cease, the whole trouble would settle on 
the lungs, producing an intense dyspnoea. To- 
wards the end of the attack a dry, wheezing 
cough would set in, continuing, until with the 
sputa, there were ejectedyellow, thread-like pieces 
of tough mucus, looking as if they had been 
dislodged from the bronchial tubes. Aralia ten 
drops, three times a day, cured in three days. 
For a more full description and knowledge of 
the action of this remedy the reader is referred 
to " Eough Notes on Aralia Eacemosa," by S. A. 
Jones, M.D., Nm^th American Journal of Homoe- 
opathy, November, 1872. 

Allium cepa. — Sneezing ; profuse, bland, 
though sometimes acrid coryza, commencing in 
the left, afterwards extending to the right nostril ; 
discharge of white mucus ; itching and burning 
in the nares ; lachrymatioji, with itching of the 



RAY FEVER, 59 

eyelids and redness of the conjunctivae ; nasal 
respiration impaired and sometimes abolished ; 
headache ; photophobia ; sleep disturbed ; appe- 
tite impaired ; violent laryngeal cough, worse in 
the evening and in a warm room. 

While there are no reported cures by this 
remedy, yet it is often valuable as an intercur- 
rent remedy for the coryza and sneezing. 

Sanguinaria Canadensis. — Frequent sneez- 
ing, aggravated by odors ; copious, watery, acrid 
coryza, causing burning and rawness of the 
pituitary membrane, with loss of smell or per- 
verted smell ; pain in th^ frontal sinuses ; (head- 
ache, arising from the back of the neck, coming 
forward to forehead and right side of head) ; op- 
pression, pain, and soreness in the upper part of 
the chest, or on the right side of the chest, with 
dijBicult, wheezing breathing ; severe dyspnoea ; 
hay asthma; wheezing, whistling, hacking or 
dry cough, sometimes followed by diarrhoea, 
which relieves the cough ; cough worse at night ; 
burning dryness of the mouth and throat, not 
relieved by drinking ; offensive sputa ; all the 
symptoms worse on the right side. 

In the V. S. Medical Investigator, (Vol. XYIIL, 
1883, page 185), Dr. Winterburn says: ^^San- 
guinaria has an important influence on the nasal 
mucous membrane. I have seen it cure a num- 
ber of fluent coryzas. It seems to act best in cases 
which affect particularly the right nostril, and 
are accompanied by much sneezing. Such cases 
often yield quickly to inhalation, through the 
nose, of the dust arising from shaking a small 



60 HAY FEVER. 

quantity of Sanguinaria in a bottle ; the inhala- 
tion to be repeated at intervals of three or four 
hours. 

*' Periodic coryzas of all sorts, from rose cold 
to autumnal catarrh, if possessing the charac- 
teristic conditions for Sanguinaria, will be cured 
by it. 

''It may be merely a coincidence, but I have 
never been able to cure polypi in the left nostril 
with Sanguinaria. There is a peculiar right- 
sidedness running through the pathogenesis of 
this remedy and its analogue, Chelidonium." 

Sanguinaria nitrate. — Our knowledge of the 
indications and conditions for the use of this 
medicine is, as yet, somewhat limited. Its action 
is similar to that of Sanguinaria Canadensis. It 
is claimed that it acts upon the hypertrophied 
tissue in the naso-pharyngeal regions better than 
any other remedy. 

In catarrhal sore throat, Dr. Winterburn re- 
commends its use in the form of a spray. He also 
reports (JJ. S, Medical Investigator, Vol. XVIII., 
1883, page 186) the cure of ''a mucous polypus, 
adherent to the septal membrane, nearly filling 
the arch of the passage, and hanging downward 
into the posterior nares." The patient was giv- 
en '-an ounce of the Nitrate of sanguinaria, first 
decimal trituration, in a two-ounce bottle, with 
orders to shake the bottle and snuff the dust 
thoroughly up the right nostril every three 
hours. The effect was slow, but in the end most 
gratifying. In two months the polyj)us had en- 



HAY FEVER. 61 

tirely disappeared, and the nasal membrane was 
healthy and has remained so." 

Arsenicum album. — This remedy is recom- 
mended by some hay-fever writers as a prophy- 
lactic. Symptomatically, it is frequently indi- 
cated for sneezing; fluent, acrid, excoriating 
coryza ; thirst for small draughts of water, and 
often ; corrosive lachrymation ; redness of the 
conjunctivse ; photophobia ; burning sensations 
in the nose, eyes, throat and chest; anxiety; 
restlessness ; prostration ; asthmatic oppression 
of the chest, with great dyspnoea ; wants doors 
and windows open, or jumps up suddenly at 
night and runs to the door or window for more 
air ; or grasps hold of something ; or sits up in 
bed, resting the head upon the hands, with the 
elbows resting upon the knees ; short, hacking 
cough with pain in the upper part of the right 
lung ; worse after midnight, from the least bod- 
ily exertion, or from a change of weather ; men- 
tal depression. Dr. J. E. James, of Philadelphia, 
says: ''I believe we have its (hay fever) rem- 
edy in Arsenicum 2nd or 3rd. It has in my 
hand effectually cured several cases. " 

Because of the presence of the specific irri- 
tant or exciting cause during the hay fever sea- 
son, Arsenicum album and other symptomat- 
ically indicated remedies do not always avail 
without the removal of the predisposing cause. 

Sticta pulmonaria. — Violent and incessant 
sneezing ; severe coryza ; hot, irritating, watery 
mucus is discharged ; afterwards it becomes 
thick, bloody, green, or yellow, followed by dry- 



62 HAY FEVEB. 

ness of the mucous membrane ; the fluent coryza 
dries quickly on a handkerchief ; the secretions 
dry rapidly, forming scabs difficult to dislodge ; 
excessive dryness of the nasal mucous mem- 
brane ; dryness of the throat, worse at night ; 
tickling in the bronchi and larynx, with racking 
cough, worse on inspiration; burning in the 
eyes ; conjunctivitis ; severe frontal headache 
with a sensation of fullness in the frontal si- 
nuses. 

Arum triphyllum. — Frequent sneezing; 
fluent coryza; nose obstructed, compelled to 
breathe through the mouth ; coryza acrid, ex- 
coriating nose and upper lip; must have the head 
elevated in order to sleep ; much itching of the 
eyelids, and inner canthi ; aversion to a bright 
light ; desire to go in the open air unless the 
sun shines brightly ; chilliness ; heat of face and 
head ; constriction of the throat ; saliva acrid ; 
burning in the mouth and throat ; soreness and 
burning sensation in the lungs ; frequent tick- 
ling cough, with mucus expectoration; asth- 
matic paroxysms. 

Ipecacuanha. — Is sometimes useful in the 
sneezing stage, but it is more prominently indi- 
cated in the asthmatic. The chest symptoms 
are the ones calling for its use. Long-continued, 
exhausting fits of coughing, with suffocative 
spells ; gasps for air at an open window ; the 
dyspnoea is intense ; constriction of the throat 
and chest ; constant, choking, asthmatic cough, 
with rattling of mucus ; wheezing, nausea and 
vomiting; loss of breath on the least motion; 



HAY FEVEB, 63 

face pale; chilliness increased by external 
warmth; in the later stages there is profuse 
mucus expectoration. 

Kali bichroraicum. — Is better adapted to 
the removal of the prime cause than to the dis- 
ease itself, though Dr. James Kitchen and others 
have used it with much benefit in hay asthma, 
especially when the quantity of mucus in the 
bronchial tubes is not as great as it appears 
to be, the expectoration being tough and 
stringy ; burning of the mucous membrane from 
the nose to the throat ; headache in frontal 
sinuses or over the left supra-orbital ridge ; 
fluent, acrid coryza ; hoarseness ; wheezing, or 
sharp ringing cough, excited by eating or drink- 
ing ; pinching pain across the bridge of the nose 
relieved by hard pressure ; plugs of green mu- 
cus in the nose ; loss of smell. 

Eupliorbium officinalis. — The main sphere 
of this medicine is for the cough. It has done 
me good service in some cases of hay fever, but I 
have not made any cures, or learned of any 
made by its use. Its indications are: — sneez- 
ing; chilliness and heat alternating; inflamed 
eyelids, glued together at night or in the morn- 
ing ; dryness of the mouth and throat ; oppres- 
sion of the chest; w^eakness and general 
prostration ; worse from draught of air or dust ; 
dry, deep, hollow cough, almost constant day 
and night, with irritation of the larynx, accom- 
panied by stitches which seems to proceed from 
the pit of the stomach to both sides of the 
chest. 



64 HAT FEVER. 

Grindelia robusta. — The use of this remedy 
is as yet empirical. I have used it but very 
little and with no satisfactory results in hay 
fever or hay asthma. It has been found to 
produce '* a suspension of respiration" which 
awakened the prover from sleep. There is 
accumulation of tenacious mucus in the bronch- 
ial tubes, with difficult expectoration; oppres- 
sion of breathing and asthma. 

Ambrosia artemisiafolia. — If the hair of 
the dog is good for the bite, then this remedy, 
according to the exclusive pollen theorists, 
should be /a^^ife princeps. The published symp- 
toms are similar to those of hay fever, as given 
in the materia medica. 

Nnx vomica. — The use of the remedy in 
hay fever was written of as early as 1852, in 
the North American Journal of Homoeopathy, Yol. 
II., page 395. The indications for its use are : — 
sneezing ; profuse, fluent coryza ; nose stopped 
up at night and dry, but fluent corj^za during 
the day ; eyes itch and burn ; dull frontal head- 
ache ; loss of appetite ; bad taste in the mouth 
mornings ; chilliness and heat alternately, espec- 
ially morning and evening; heat of the head 
and face ; constipation ; hemorrhoids ; in the 
asthmatic form, with the occurrence of violent 
paroxysms of coughing in the evening after 
lying down, and especially if the expectoration 
is absent or scanty and tenacious. 

Gelsemium sempervirens. — Often gives re- 
lief at the time of the premonitory symptoms. 
It is of excellent service in the outset of a cold 



HAY FEVFAi. 65 

in the head. There is sneezing, tingling and 
obstruction of the nose ; fluent coryza ; watery 
corrosive discharge ; pain in the back of the 
head ; sneezing in the morning on first getting 
up ; profuse lachrymation. Drs. Lippe and 
Hale give as its key-note, *' violent sneezing in 
the morning." There are no reported cures by 
its use, and as a curative agent it has proven to 
be more theoretical than practical. 

Mercurius sol. Hahn.; Mercurius dulcis; 
Mercurius sublimatis corrosivus and Mercu- 
rius protoiodatus. — Frequent sneezing, mth 
swelling, redness and soreness of the nose ; acrid, 
excoriating discharge ; pains in the head, face, 
ears, teeth and extremities ; violent, racking, un- 
ceasing cough, worse at night; chilliness with 
slight fever ; tongue heavily furred ; profuse non- 
alleviating sweat ; burning in the posterior nares ; 
mucus of an unpleasant odor; aching, itching 
and burning of the eyes, chiefly in open air; 
lachrymation, glueing the eyelids together ; 
thirst ; heat is uncomfortable, but patient cannot 
bear cold air. Mercurius protoiodatus is the 
one generally preferred, on account of its marked 
action in diseases of the nose and throat, and 
because of its being more suitable to the condi- 
tions that cause hay fever. 

Aurum metallicum and Muriaticum.— 
Itching of the nose ; constant sneezing, fluent 
coryza or stoppage of the nose ; the eyes become 
involved by itching and photophobia : especially 
w^orse in sunlight ; sneezing worse from efl-'ects 
of sunlight ; the nose and eye symptoms are 



66 HAY FEVEB. 

worse in the morning, better from midnight to 
morning ; morning asthma ; face blue ; palpita- 
tion of the heart; suffocative attacks, with 
spasmodic constriction of the chest. Several 
writers have reported good results from its use, 
but no absolute cures have been reported. 

Natrum muriaticiim. — Sneezing, worse 
when undressing at night, or on rising in the 
morning ; excoriating, waterj^ discharge from the 
nose, with sensation of squirming in right nos- 
tril as of a small worm there ; bland discharge 
from the eyes ; they smart when reading ; smell 
acute. Dr. Hawkes, (Clinique, Vol. I., 1880, 
page 94), reports the cure of a case of hay fever 
of eighteen years' standing with Natr, mur, 200, 
a powder every night for four nights. The his- 
tory of the case showed that asthma supervened 
upon the suppression of a severe attack of fever 
and ague with large doses of Quinine. There 
was no history of asthma in the family. The 
chills were tertian and appeared at 10 A.M., 
but under the influence of Quinine came irregu- 
larly. The lips and around her mouth were so 
thickly covered with fever blisters that she could 
not eat, speak, or use her mouth in any way 
without great difficulty and pain. There was a 
marked desire for salt. The examination of the 
patient elicited: ''Constant and distressing 
sneezing and coughing ; nose ' stuffed ' or * run- 
ning' all the time ; cannot lie down from 8 P.M. 
to 5 A.M., on account of distressing dyspnoea; 
sits up and smokes Saltpeter and Stramonium 
all the night in order to get breath ; cough dis- 



BAY FEYETt. 67 

tressing and constant; great soreness in the 
chest ; appetite poor ; much headache ; cannot 
be in a room where dusting or sweeping is going 
on ; cannot walk in the street when dust is fly- 
ing; the least dust of any kind distresses her 
and makes her gasp for breath. Her worst 
time is during the month of November. This 
had been her condition during the fall month 
for eighteen years. She left home for relief 
nearly every season. Sometimes she experi- 
enced partial relief; other times none. Site 
still desires a great quantity of salt ivith Iter food. 

The doctor concluded ''that the cause of the 
• hay fever ' was the maltreatment of the inter- 
mittent fever eighteen years ago, and that the 
remedy indicated for the patient while suffering 
with that disorder was the one indicated in the 
present condition," and that ''the symptoms 
indicating the remedy were : The time of the 
chill, 10 A.M. ; the profuse eruption of fever 
blisters, and especially the craving for salt, which 
was still present." The prescription was given 
Sept. 7th, 1879, and on Sept. 29th, 1879, the 
patient reported, "entirely free of all former 
symptoms of her old enemy and cured." 

The doctor claims that "this case tends to 
prove the truth, that hay fever is as amenable 
to treatment by the indicated remedy as are 
other diseases." Being desirous of knowing the 
idtiviatuvi of the treatment in this case, I wrote 
Dr. H. Sept. 21st, 1887, and received the fol- 
lowing, dated Sept. 29th, 1887. "In reply will 
say that the case of hay fever reported as cured 



68 HAY FEVER. 

with Natr, mur, 200, remained well for that sea- 
son ; but that she was ill again the next season 
with the old trouble, although not quite so 
severely as on former occasions. Natrum mur. 
did her no good the second season, and the 
patient was so discouraged, she did not give me 
an opportunity of trying further for the remedy. 
This was the only satisfactory case of this 
annoying disease I have had. As a rule they 
do not give us an opportunity, being, as they 
are, under the impression that there is no relief 
from it, except change of climate. My view of 
it is that the predisposing cause of these cases 
is psoric, and that they are to be treated homoe- 
opathically, just as we treat all others, accord- 
ing to the "totality of the symptoms." 

We have in the above reported cure, not a 
permanent cure, but a palliation or cure of the 
existing attack, and no prevention of future 
attacks. With a true conception of the aetiology 
and pathology of hay fever, Dr. Hawke's views 
and treatment will change. A strict reliance 
upon symptomatology alone, in the treatment of 
hay fever, will cause many failures. The above 
is a fair illustration of some of the reported 
cures, and about the purport of the rei^lies to 
inquiries concerning reported cures and the 
theories of the causes of the disease. 

Calcarea carbonica. — Dr. W. S. Gee, 
{Homoeopathic Physician, Vol. IV., 1884, page 355), 
reports the cure of a case of hay fever, of ten 
years' duration, with Calcarea carb. mm. In 
reply to my letter of inquiry, he says: ''The 



HAT FEYEH. 69 

case reported in the Homoeopathic Physician is 
mine. The disease returned the next year, but 
not so hard. I have treated others with relief, 
but in the main they are unsatisfactory to deal 
with. I believe the ' psoric ' miasm is at the 
base in every case, and must receive treatment 
as for any chronic disease." Comment is 
unnecessary. 

Lobelia iuflata. — Hay asthma. The attack 
is preceded by a prickling, nettle-like sensation 
all over ; little or no cough. 

Moschus. — Hay asthma in persons of a 
nervous, irritable, or hypochondriac tempera- 
ment ; violent constriction of the throat, without 
cough; can't sleep during the whole night. 

Pulmo yulpis. — Von Grauvogl used a first 
centesimal trituration as a remedy in an old 
subject suffering with asthma humidum, and 
met with brilliant success. — {Arndfs System of 
Medicine, Vol. I., page 315.) 

The venerable S. A. Jones, M.D., {Amerimn 
Observer, Vol. H., 1874, page 632), gives some 
valuable hints, as well as the results of his expe- 
rience and that of others, in the use of this 
medicine. This article and the reported cure 
are well worth reading, but too long to report 
here. 

Camphor. — '* First cent. trit. has been fol- 
lowed for some hours after each dose by decided 
amelioration." — (W. H. Holcombe, U. S. M.and 
S. J., Vol. Vm., page 180.) 

Sambuciis nigra, — When the degree of 
dyspnoea is greater than that of Ipec, and 



to It AY FEYEk. 

the cough less; extreme anxiety; face purple; 
asphyxia seems imminent; loud sibilant rales 
accompany the dyspnoea ; free perspiration ; the 
patient seems to sleep into the trouble. 

Hippomanes mancinella. — Dr. B. W. 
James, (U. S. Medical Investigator, Vol. IV., 
1876, page 424), says: '*I have seen rapid 
improvement follow the use of it, especially 
where the attacks occur at night. We previ- 
ously used Arsenicum in these cases.'' 

Sulphur. — Sneezing on awakening in the 
morning, or on lying down at night. It is most 
useful where there are occasional attacks of 
urticaria, and in that form of hay fever where 
asthma is the special feature from the com- 
mencement of the attack. Profuse perspiration 
after the fitsof sneezing or coughing; oppression 
of breathing between the paroxysms; sibilant 
dyspnoea ; bluish lips ; expectoration of a tena- 
cious bronchial mucus ; burning sensation in 
the larynx and trachea; violent paroxysms of 
coughing in the evening after lying down ; con- 
stipation; hemorrhoids; skin affections. 

Lachesis. — Long paroxysms of sneezing; 
profuse, acrid, coryza, causing excoriation, 
swelling, and redness of the nose ; lachrymation 
with conjunctiva injected ; violent, tickling, 
irritative cough, as if a hair were in the throat ; 
constriction of the throat and lungs ; oppression 
of breathing with pain in the lungs ; sensitive- 
ness of the larynx with a feeling of suffocation 
when touched; dyspnoea worse after sleep at 
night, after eating and after a nap in the day- 
time ; prostration. 



I/AY FEVER. 71 

Dr. W. H. Holcombe has obtained brilliant 
palliative results with this remedy at the 2,000th 
attenuation. 

Aconitum radix. — This medicine is recom- 
mended by many writers, but mainly at the 
onset of the malady, or for febrile disturbance ; 
chilliness, or creeping chills ; aching ; profuse 
watery coryza ; nervousness ; restlessness ; anx- 
iety ; coryza suppressed, followed by headache, 
or fullness of the head, heat in the nasal cav- 
ities, with frequent paroxysms of sneezing; dry, 
violent, racking cough, with stitches in the 
chest ; photophobia, with a feeling as of sand in 
the eyes ; haemoptysis. 

Euphrasia officinalis. — Frequent sneezing; 
profuse coryza and lachrymation ; discharge of 
white mucus from the nose ; severe itching and 
burning at the margins of the eyelids, with 
swelling and glueing of the edges ; photophobia ; 
dry, tickling cough; dyspnoea. It is indicated 
when the force of the disease is concentrated on 
the eyes. 

Drosera rotundifolia. — When the cough 
accompanying this disease assumes a distinctly 
paroxysmal character, as if it partook of the 
nature of whooping cough. 

Tartar emetic. — Sneezing; stoppage of nose 
alternating with fluid discharge ; loose rattling 
cough, rattling of mucus, with little or no ex- 
pectoration ; oppression of breathing ; nausea ; 
aching in the muscles and joints ; loss of taste 
and smell. 



72 HAY FEVER. 

Pulsatilla. — Sneezing; coryza fluid or dry, 
or the discharge is of considerable consistence, 
thick, yellow or green, and sometimes offen- 
sive ; there is an alternate stoppage and dis- 
charge ; discharge more copious in the open air ; 
loss of taste and smell; abundant catarrhal 
expectoration; chilliness; vertigo; prostration; 
palpitation of the heart ; aversion to milk and 
fat food. 

Teucrium manim verum. — ^' The eyes look 
as if one had been weeping, with smarting in 
the canthi and redness of the conjunctiva. 
Eedness and puffiness of the upper eyelids. 
Profuse smarting tears in the open air. Fine 
ringing in right ear when blowing the nose, 
squeaking as if air were forced through mucus. 
Tingling (itching) in the nose. Stinging, lan- 
cinating pain in the upper part of the nasal 
cavity. Frequent sneezing, with tingling in the 
nose without corj^za (or followed by coryza). Sen- 
sation in one nostril as if it were half stopped," 
— A, L.Fisher, M.D,, U.S. Medical Investigator, 
Vol. XII., 1880, page 187. 

Sinapis nigra. — The venerable J. P. Dake, 
M.D., Nashville, Tenn., suggested to me the use 
of the ethereal oil of Sinapis nigra, by inhala- 
tion, to relieve the sneezing and check the 
abundant coryza. He informed me that he had 
found it of great service in cases of acute coryza. 
His plan of use is to saturate a bottle of pellets 
and inhale from them. 

C. A. Groves, M.D., (North American Journal 
ofHomoeojjathy, Vol. XXIX., 1880-81, page 630), 



HAY FEVER. n 

says: " Dr. Butler, of Montclair, New Jersey, 
has relieved a number of cases with Sinapis 
nigra, and recommends the remedy." 

Natrum ar^enicosum. — ^^This prompt and 
most searching medicine can go far in the cure 
of the predisposing cause of this poisoning ( ?). 
Besides the burning which is so characteristic 
of this disease, it has scores of other symptoms 
which show it to be favorable to many cases." 
— J. E. Jones, M,D,, Medical Advance, Vol. 
XVIIL, 1887, page 564. 

Cuprum aceticum. — ''If persevered with, 
cures many a case. Its nightly aggravation, 
burning excoriation, violent cough in paroxysms, 
fears of suffocation, burning pains, tough, te- 
nacious phlegm, etc." — J. E. Jones, M.D,, Med- 
ical Advance, Vol. XVIII., 1887, page 564. 

Ammonium bromide. — ''In cases where 
the usual attendant symptoms are accompanied 
with a violent tickling cough. It also has 
more than a mere palliation ; there is a chang- 
ing of the diathesis." (?) — J. E, Jones, M,D,, 
Medical Advance, Vol. XVIII., 1887, page 564. 

Kali bromidum. — Dr. C. H. Blackley, says : 
^'Bromide ' of iMassiuni had some influence in 
delaying the attacks, but it was very feeble." 

Iodide of mercury cum Iodide of potas- 
sium. — Dr. C. H. Blackley says : " This drug 
seemed, so far as I could judge by the few trials 
I had an opportunity of giving it, to promise 
excellent results ; but as these results cannot be 
considered a sufficient test of its value, it will not 
be well to speak too confidently of it." 



74 ffAY FEVER. 

Ailantlius glaiidulosa. — Copious, thin, ichor- 
ous, bloody discharge from the nose. 

ALmmoniuin muriaticum. — 'Burning in the 
eyes, and lachrymation at night ; rawness and 
soreness in the fauces ; is obhged to clear the 
throat frequently ; burning in small sjjots in the 
chest ; itching in the larynx ; dyspnoea on 
moving and when lying." — Kipixix on Fevers, 
1884, page 131. 

Asarum Europeum. — '' Fluent discharge 
with deafness ; sensation as if the ears were 
plugged up with something." — Kivpaxon Fevers, 
1884, page 132. 

Bovista. — ''Is specially indicated when the 
patient complains of fullness at the epigastrium ; 
has to leave the clothing loose. The low dilu- 
tions are apt to aggravate, but the high act 
well. If you give the tincture in water, keep 
away from the patient till he forgets how much 
suffering it caused. — Advice from experience." 
— Transactions Massachusetts Homoeopathic Medi- 
cal Society, 1871 to 1877, Vol. IV., page 574. 

Badiaga. — "Spasmodic cough, with sneez- 
ing and lachrymation. Yellow viscid mucus 
flies from the mouth and nostrils during the 
paroxysm." — KipiJax on Fevers, 1884, page 
132. 

Belladonna. — Is useful as an intercurrent 
remedy for the complication of neuralgia of 
right temple and eye ; photophobia ; wants to 
sleep and cannot ; soreness of throat ; flushed 
face. 



HAY FEVEIt. 75 

Carholic acid, — Coryza ; lachrymation ; 
short, dry cough ; dyspnoea ; inahility to lie 
down. 

Cyclamen Europeum. — ''When therein a 
great deal of sneezing, with rheumatic pains in 
the ears and head. Loss of smell." — Kippax 
on Fevers, 1884, page 132. 

Ciipruni metalliciim. — Where the asthmat- 
ic attacks are sudden, or in the purely nervous 
asthma ; respiration spasmodic ; complicated 
with cramps and convulsive twitchings. 

Hepar sulphuris calcarea. — 'A tight 
cough with elevation of the shoulders with 
each inspiration." — Transactions Massachusetts 
IIoniQ'opathic Medical Socicti/, 1871 to 1877, A^ol. 
IV., page 574. 

Opium. — Dr. C. H. Blackley, [Haij Fever, 
Second edition, 1880, page 274), says : '' Ojmim 
is a remedy that often does good service in the 
asthmatic form of hay fever when paroxysms of 
suflocation come on during sleep, and when 
these are apt to be followed by violent fits of 
dry, racking cough that are relieved for a time 
by drinking a glass of water." He advises the 
first decimal attenuation. 

Rumcx crispiis. — Violent and rapid sneez- 
ing ; fluent coryza, with painful irritation in the 
nostrils ; dryness of the posterior nares ; violent, 
dry, periodical and paroxysmal cough, with sore- 
ness therefrom behind the sternum. 

There are other remedies recommended for 
use in this disease, but the provings of none of 



HAY FEYER. 



them point to their homoeopathicity from a 
symptomatic standpoint. Some of them might 
be useful as intercurrent remedies for comphca- 
tions which arise. 



THE END. 



INDEX. 

Page. 

Aconitum raclix 71 

Adenoid vegotiition " 44 

i^,tiology : 22 

AiliintliTis gliindulosa 74 

Allium cepa 58 

Ambrosia artemisifolia 64 

Am.moniiim bromide 73 

Ammonium muriaticum 74 

Aralia racemosa 57 

Arsenicum album 61 

Arsenicum iodatum 55 

Arum tripliyllum 62 

Asarum Europeum 74 

Aurum metallicum 65 

Aurum muriaticum 65 

Badiaga 74 

Belladonna 74 

Bovista 74 

Calcarea carbonica 68 

Camphor 69 

Carbolic acid 75 

Chronic rhinitis 42 

Cocaine 44 

Cuprum aceticum 73 

Cuprum metallicum 75 

Cyclamen 75 

Detinition 8 

Diagnosis 36 

Drosera rotundil'olia 71 

Euphorbium officinalis 63 

Euphrasia officinalis 71 

Gelsemiimi sempervirens 64 

Geographical distribution 13 

Grindelia robusta 64 

Hepar sulphuris calcarea 75 

Hippomanes mancinella 70 

History 15 

Iodide of Mercury cum Iodide of Potassium 73 

(i) 



ii INDEX. 

Page. 

Ipecacuanlia 62 

Kali bicliromicum 63 

Kali bromidum 73 

Kali liyriodatum 56 

Lacliesis 70 

Lobelia intlata 69 

Mercuriiis diilcis 65 

Mercnrins proto- iodatus 65 

Merciirius Holnbulis Haliiiemanni 65 

Merenrius ynblimatis corrosivus 65 

Mosclins 69 

Naplitlialin 47 

Natrum arsenicosiim 73 

Natnim muriaticum 66 

Niix vomica 64 

Opium 75 

Pathology 32 

Prognosis 36 

Pulmo vulpis 69 

Pulsatilla 72 

Qiunine 39 

lUmiex crispus 75 

Sabadilla 54 

Sambucus nigra 69 

Sanguinaria Canadensis 59 

Sangninaria nitrate 60 

Sanitary resorts , 37 

Sinapis nigra : 72 

Stieta pulmonaria 61 

Sulplinr 70 

Synonyms 7 

Tartar emetic 71 

Tencrinm mariim verum 72 

Therapeutic indications 47 

Treatment ... 39 

Vaseline spray 42 

Varieties 10 



K^ 



